This week’s notable decision is Metlife Life & Annuity Co. of Connecticut v. Akpele, No. 16-15677, __F.3d__, 2018 WL 1527147 (11th Cir. Mar. 29, 2018), an interpleader action brought by MetLife to determine the proper beneficiary to the proceeds of a life insurance policy purchased by Dr. Akpele to fund the AIE Surgical Practice Defined Benefit Plan that he had established as its sole member and trustee pursuant to ERISA. The case involves a complicated procedural history, so I’ll just summarize the major issues the Eleventh Circuit decided as to the proper amount and beneficiary of the disputed proceeds.
Continue Reading In Life Insurance Dispute, the Eleventh Circuit Holds that a Party Who Is Not a Named Beneficiary May Not Sue the Plan for Any Benefits
No Remedy for Breach of Fiduciary Duty Related to Group Life Insurance Enrollment
This week’s notable decision, Schwartz v. Keolis Commuter Servs., No. 16-CV-11506-LTS, 2018 WL 1411202 (D. Mass. Mar. 20, 2018), involves the mishandling of an employee’s group life insurance enrollment and evidence of insurability. Though post-Cigna Corp. v. Amara we have seen courts find cognizable claims for breaches of fiduciary duty that used to have no remedy, this unfortunate case is an example of when a breach of fiduciary duty lacks a remedy because there is no recognizable harm.
In this case, the employee, Sofiya Schwartz, started working for Massachusetts Bay Commuter Railroad Company (“MBCR”) in February 2005. A few years later, she attempted to enroll for Supplemental Life Benefits in the amount of two times her salary. Because she was a late entrant, she also submitted to MBCR evidence of insurability, which MBCR forwarded to Unum. Unum denied her request due to her history of myelopathy.
Continue Reading No Remedy for Breach of Fiduciary Duty Related to Group Life Insurance Enrollment
Insurance Company Must Pay AD&D Benefits for Death By Autoerotic Asphyxiation
This week’s notable decision is Tran v. Minnesota Life Ins. Co., No. 17-CV-450, 2018 WL 1156326 (N.D. Ill. Mar. 5, 2018), a case involving a denial of accidental death & dismemberment (AD&D) benefits on the basis of policy exclusions for intentional injuries. Here, the insured’s death was caused by “Asphyxia due to hanging, autoerotic in nature.” Following his death, the insured’s wife submitted a claim for AD&D benefits under the insured’s group policies. As you might have guessed, Defendant Minnesota Life denied the claim. Its rationale was that the insured intentionally put a rope around his neck to cut off the air flow to the lungs and blood flow to the brain, resulting in lost consciousness and death. Since the death resulted from a self-inflicted injury, the policies’ exclusions for death caused by self-inflicted injuries apply.
In appealing the claim denial to Minnesota Life, Plaintiff submitted evidence showing that her husband’s death was accidental in nature and that he did not intend or attempt to self-inflict injury to himself. She explained, “[a]lthough perhaps more unusual, autoerotic asphyxiation is no different than sky-diving, motorcycle riding, or sailing, in that they are activities people take part in for enjoyment, but which may conceivably lead to their death in the event of accident.” Defendant obtained a report from a doctor who explained that the risk of death from autoerotic asphyxia is high because the practitioner is alone and unconscious. Defendant upheld its claim denial and Plaintiff filed suit.
Continue Reading Insurance Company Must Pay AD&D Benefits for Death By Autoerotic Asphyxiation